Get Answer: Please Need Help Question Guide
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Break the problem into smaller parts and analyze each logically.
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Original Question
Please I need help with this Case Studies: CASE 1. Darrell Johnson is a 62-year-old male who comes to the Emergency Room with a 4-day history of increased sputum production, a change in the character of sputum, increased shortness of breath, and a fever of 101° F. His HR is 56, BP 110/60, RR 24. He has a smoking history and history of asthma and has been hospitalized twice with pneumonia, most recently 2 years ago. He has an ongoing constipation problem that he takes Magnesium Citrate every other day. Initial priority assessment is completed by the nurse and the client is then admitted to a medical unit with pneumonia. The nurse analyzes ABG results and establishes the priority nursing diagnosis of Ineffective Airway Clearance. Medications are prescribed. Nursing actions related to the administration of the prescribed ampicillin and albuterol are identified, and the nurse teaches the client how to use a metered dose inhaler. ABG Normal Pt Value pH 7.33 PaCo2 46 HCO3 21 O2 Saturation 92% Electrolytes Na 136 K 3.7 Cl 99 Total Ca 10 Mg 2.7 Phos CASE 2. Helen Jackson, a 63-year-old Caucasian female, arrives at the surgery center for her preoperative appointment. She is scheduled to have surgery on her left femur due to bone cancer. During preoperative screening, the nurse recognizes abnormal vital signs (HR 108, RR 24, BP 124/70 and T 98.6) and lab tests, and patient reporting not feeling like eating for a while. Preoperative teaching includes evaluating the client’s deep breathing techniques and responding to the client’s concerns about getting a pressure sore and overdosing on pain medication through a PCA pump. A week later, Ms. Jackson arrives 3 hours before her scheduled surgery. The nurse confirms the client’s NPO status and the markings on the client’s hips and takes action in response to the unsigned surgical consent form. In the Operating Room, the nurse establishes a priority diagnosis and calls a time out. In the immediate postoperative period, the nurse positions the client and documents the appearance of the surgical dressing. When Ms. Jackson is transferred to the surgical unit, the nurse first needs to calculate an IV infusion drop rate, and when an infusion pump becomes available, an IV rate in ml/hour. ABG Normal Pt Value pH 7.46 PaCo2 33 HCO3 25 O2 Saturation 99% Electrolytes Na 138 K 3.4 Cl 102 Total Ca 12 Mg 2.5 Phos 2.8 What clinical manifestations does the patient have? What would be the priority Nursing Diagnosis (choose one). Interpretation of Electrolyte abnormality (which electrolyte is most concerning)? What symptoms does the patient have specific to the electrolyte abnormality? What treatment would you expect based on the problem? What nursing interventions would you expect?
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